Dr. Wilson and Dr. Rampa are with the College of Public Health, University of Nebraska Medical Center, Omaha; Dr. Trout is with Peru State College, Peru, Nebraska; and Dr. Stimpson is with the Graduate School of Public Health and Health Policy, City University of New York, New York.
Psychiatr Serv. 2017 Dec 1;68(12):1303-1306. doi: 10.1176/appi.ps.201700017. Epub 2017 Sep 1.
This study characterizes telehealth claims for mental health and substance abuse (MH/SA) services by using national private claims data.
Telehealth-related mental health service claims were identified with private claims data from 2009 to 2013. These data-provided by the Health Care Cost Institute-included claims from Aetna, Humana, and UnitedHealth for more than 50 million individuals per year.
In 2009-2013, there were 13,480 MH/SA telehealth provider claims out of 3,986,159 claims, with the majority of telehealth claims submitted by psychiatrists. For telehealth services, there was a decreasing trend for average reimbursements ($54.61 in 2009 to $43.28 in 2013). Average reimbursements for telehealth claims were half those for nontelehealth claims. Reimbursements for nine of the top 10 telehealth services were lower in 2015 dollars than for the same services provided during face-to-face treatment.
Widespread adoption and use of costly telehealth technologies for mental health services may be limited by low reimbursements for telehealth services.
本研究通过使用国家私人理赔数据，对心理健康和物质滥用（MH/SA）服务的远程医疗理赔进行特征描述。
使用 2009 年至 2013 年的私人理赔数据，从 Aetna、Humana 和 UnitedHealth 等公司的理赔数据中确定了与远程医疗相关的心理健康服务理赔。这些由医疗保健成本协会提供的数据每年包含超过 5000 万人的理赔信息。
在 2009 年至 2013 年期间，3986159 份理赔中共有 13480 份 MH/SA 远程医疗提供者理赔，其中大部分远程医疗理赔是由精神科医生提交的。对于远程医疗服务，平均报销额呈下降趋势（2009 年为 54.61 美元，2013 年为 43.28 美元）。远程医疗理赔的平均报销额是面对面治疗的非远程医疗理赔的一半。在 2015 年美元中，十大远程医疗服务中的九项服务的报销额低于提供面对面治疗时的服务报销额。
由于远程医疗服务的报销额较低，心理健康服务中广泛采用和使用昂贵的远程医疗技术可能受到限制。
